Citation

Andreollo NA, Lopes LR, Tercioti V, Brandalise NA, Leonardi LS. Arq. Gastroenterol. 2003; 40(3): 148-151.

Copyright

(Copyright © 2003, Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia)

DOI

10.1590/s0004-28032003000300003

PMID

15029389

Abstract

BACKGROUND: The esophageal stenosis secondary to the ingestion of caustic products is frequent in Brazil, mainly due to an attempt suicide. The Barrett's esophagus is consequence of the chronic gastroesophageal reflux. The literature consulted showed that are a rare association.
CASUISTIC AND METHODS: From 1981 to 2000 were admitted and treated in the "Gastrocentro" State University of Campinas, SP, Brazil, 120 patients presenting caustic stenosis of the esophagus, and during the follow-up were found nine cases with Barrett's esophagus associated (7,5%). The time of caustic ingestion varied from 4 years to 54 years (mean 29 years), and they were four males and five females, eight whites and one black, with the mean age of 57,7 years (43 to 72 years).
RESULTS: All the cases presented dysphagia and the flexible upper endoscopy showed stenotic areas and caustic esophagitis sequels. Three patients referred symptoms of gastroesophageal reflux, but hiatus hernia were found in only one case. The Barrett's esophagus was found in the middle third of the esophagus above the stenotic areas in three cases, and in the distal third in six cases. The dysphagia was treated with periodic esophageal dilatations. Two patients presenting severe symptoms of reflux were submitted to modified Nissen fundoplication by videolaparoscopy, with good results.
CONCLUSIONS: The Barrett's esophagus in these patients could be associated to the caustic ingestion, because it is not situated in the distal third of the esophagus, as commonly found in reflux esophagitis. Its is very important the follow-up and biopsies of the Barrett's esophagus, due to the possibility of malignancy.

Language: pt

Keywords

Adult; Aged; Barrett Esophagus; Burns, Chemical; Caustics; Esophageal Stenosis; Female; Gastroesophageal Reflux; Humans; Male; Middle Aged